Evaluating found space in health facilities

As we begin 2021, we realize that business and operations are still far from what they once were. Health care organizations are finding themselves with a surplus of newfound space. Clinical practices are shifting to telemedicine; nonclinical staff are working remotely. This space has forced health care planners to reexamine their needs and has raised the question, “What space do you really need to deliver care?”

Facilities professionals must have accessible tools at their disposal to simplify this complex question and define the purpose of their space. Among these tools are the following three primary elements on which facilities professionals can focus to adjudicate the true purpose of their physical spaces:

1. Assessment. Facilities professionals look at infrastructure performance and maintenance but don’t necessarily observe how the environment affects them. Holistic assessments are necessary to evaluate buildings and their viability. This allows for an evaluation of their ability to contribute to the bottom line. It is necessary to address the following aspects of how assessments should be conducted: 

• Infrastructure. This includes understanding the cost of a building over its lifetime through life-cycle costing. It is important to include all aspects of the building, operations, maintenance, planning and capital improvements. 
• Maintenance. Maintenance assessments need to look at all systems holistically to assure they are functioning at their optimum. This includes review of environmental services and facilities, cost and operations, maintenance, supply storage and engineering. 
• Operational. Mapping and reviewing the operations includes all aspects of health care delivery from the referral call to patient discharge and ongoing in-home care. Using flow maps and Lean models ensures supplies, processes and outcomes are smooth and seamless.  
• Experiential. Using HCAHPS, organizations can use patient experience and staff engagement as key indicators of success. These assessments track how these experiences can be improved. This also should include wayfinding and visibility assessments.  
• Branding. Brand assessments review how an organization is seen, experienced and reinforced. Organizations use this to determine consistency, reputation, honesty, trust and follow-through.

2. Alignment. True alignment occurs when organizations can utilize the data they collect and position it to achieve desired outcomes. While alignment is very complex, we have outlined these critical systems to assure that organizations are set up for success:

• Services. Determine why services are offered and if they support the needs of the community. 
• Operations. Determine how care is delivered and create successful systems. Care delivery needs to be fully envisioned as a continual loop. Look to integrate automation and/or predictive analytics to ensure operational performance.
• Infrastructure. Determine where care is occurring beyond the walls of the facility. As our society has been forced to shift into virtual-first methods of care, telemedicine and home-based care must be the cornerstone of a virtual strategy. 
• People. Health care is moving to more personalized care, and consumers demand more from the system at home and at the health care site. Develop a clear way to attain feedback through more immediate survey tools. 
• Cost. Determine the total cost of owning the building, including planning, design, construction, operation and maintenance. Cost also can be return on investment, which is looking at the amount of money returned for an investment as well as net present value, which uses projected cost over time to determine the profitability of a project.

3. Amplification. Reviewing the needs of patients during the pandemic allows for an understanding of the right outcomes for an organization. Think through the following prompts to stimulate areas of amplification in your organization:

• Grow. How are you looking to grow your service, market, community reach or performance? 
• Capitalize. How will you use this investment or new alignment to capitalize on the opportunity?  
• Escalate. How will this help your organization move to the next level quickly?
• Specialization. How can you use this decision to deepen your expertise or impact? 

Health care is undergoing the most substantial paradigm shift in its history. This presents an opportunity to enhance processes by using the new frontier and the heightened awareness that goes in tandem with the pandemic. 

New strategies to adapt to these changes are an absolute necessity and require a transformation that focuses on holistic approaches. These changes will ultimately allow organizations to ensure that their systems, operations and facilities fulfill what is required to deliver care. 

Lorissa MacAllister Ph.D., AIA, LEED AP, founder and president of Enviah, Grand Rapids, Mich.